NLE Disaster Nursing & Crisis Response Reviewer 2026

Answer: B. To achieve the greatest good for the greatest number of victims

Step 1: In routine nursing, the goal is to give the best possible care to the individual patient in front of you. Step 2: In a disaster or mass-casualty incident (MCI), resources — nurses, doctors, supplies, equipment — are overwhelmed and insufficient for everyone. Step 3: The guiding principle therefore shifts to a population-based approach: allocate limited resources where they will save the most lives. Step 4: This means a nurse may have to bypass the most severely injured (expectant/black) patient to save multiple salvageable (red) patients. Step 5: Option A is wrong because it describes individual-focused care. Option C is wrong because equal distribution in a disaster wastes resources. Option D is wrong because triage is clinically, not socially, based.

Answer: C. Mitigation

Step 1: Identify the key action — hazard mapping and route reinforcement are being done BEFORE any eruption. Step 2: Mitigation refers to actions taken before a disaster to prevent it or reduce its impact (the 'lessening' phase). Step 3: Preparedness also happens before a disaster, but it focuses on planning, training, stockpiling supplies, and conducting drills — NOT on structural/environmental modification. Step 4: Response happens during and immediately after the disaster. Step 5: Recovery happens after the disaster to restore the community. Because hazard mapping and structural reinforcement of routes directly reduce the risk and impact of a future volcanic eruption, this is Mitigation.

Answer: B. Preparedness

Step 1: The nurse is conducting a drill and updating a family communication plan — both are readiness activities done BEFORE a disaster. Step 2: Preparedness = planning and readiness activities before a disaster so that when it occurs, the response is organized and effective. Step 3: Mitigation differs because it focuses on reducing hazards (e.g., building earthquake-resistant structures), not on training people how to respond. Step 4: Response involves acting during or immediately after the event. Step 5: Recovery involves rebuilding after the disaster. Drills and communication planning are classic Preparedness activities.

Answer: C. Green – Minor

Step 1: The START system begins with a simple instruction — the triage officer calls out for anyone who can walk to move to a safe area. Step 2: Anyone who walks on their own is considered to have minor injuries — they have enough neurological and cardiovascular function to ambulate. Step 3: These victims are tagged GREEN (Priority 3 – Minor), also called the 'walking wounded.' Step 4: They are treated last among all groups but can often assist with simpler tasks. Step 5: Red = life-threatening but salvageable; Yellow = serious but stable; Black = deceased or unsurvivable. Walking victims do NOT qualify for Red, Yellow, or Black at initial assessment.

Answer: D. Black – Expectant/Deceased

Step 1: In START, the first parameter assessed for non-ambulatory victims is Respirations (the 'R' in RPM). Step 2: If the victim is NOT breathing, the nurse opens/repositions the airway. Step 3: If breathing does NOT resume after airway opening, the victim is tagged BLACK (deceased/expectant) — no further resuscitation is done in a mass-casualty setting. Step 4: This is a key departure from normal CPR protocols — in a disaster, resources cannot be spent on victims with no chance of survival. Step 5: If breathing HAD resumed after airway opening and RR was >30, the tag would be Red. Black is only assigned here because breathing did not return even after the airway maneuver.

Answer: B. Yellow – Delayed

Step 1: Work through the RPM parameters in order. Step 2: Respirations = 24/min — this is ≤30/min, so the victim PASSES the breathing check (no Red flag here). Step 3: Perfusion = radial pulse present — adequate perfusion, passes the perfusion check (no Red flag). Step 4: Mental status = can follow a simple command ('squeeze my hand') — this means mental status is INTACT. Step 5: A victim who passes all three checks (RR ≤30, adequate perfusion, follows commands) is tagged YELLOW – Delayed, meaning they have serious injuries but are stable enough to wait for treatment. Red would require failing at least one parameter; Black is for no breathing; Green is for ambulatory victims.

Answer: B. Atropine and pralidoxime

Step 1: Nerve agents like sarin inhibit acetylcholinesterase, causing a buildup of acetylcholine and excessive cholinergic stimulation (SLUDGE: Salivation, Lacrimation, Urination, Defecation, GI distress, Emesis; plus bronchospasm and bradycardia). Step 2: Atropine is an anticholinergic agent — it blocks muscarinic receptors and counteracts the excessive acetylcholine buildup. Step 3: Pralidoxime (2-PAM) reactivates acetylcholinesterase if given early, before 'aging' of the enzyme occurs. Step 4: Together, atropine + pralidoxime = the standard nerve agent antidote. Step 5: Naloxone reverses opioids; Flumazenil reverses benzodiazepines; Potassium iodide protects the thyroid from radioactive iodine; Epinephrine is for anaphylaxis — none of these treat nerve agent poisoning.

Answer: C. Potassium iodide

Step 1: In a nuclear or radiological event, radioactive iodine (I-131) can be released into the environment. Step 2: The thyroid gland absorbs iodine — it cannot distinguish between stable and radioactive iodine. Step 3: If radioactive iodine is absorbed by the thyroid, it can cause thyroid cancer, especially in children. Step 4: Potassium iodide (KI) saturates the thyroid with stable (non-radioactive) iodine, preventing it from absorbing the harmful radioactive form. Step 5: Activated charcoal absorbs toxins in the GI tract; Atropine treats nerve agent poisoning; Sodium bicarbonate alkalinizes urine (used in some poisonings). None of these protect the thyroid from radioactive iodine.

Answer: B. National Disaster Risk Reduction and Management Council (NDRRMC)

Step 1: RA 10121 was enacted in 2010 and fundamentally changed the Philippines' approach to disasters. Step 2: It replaced the old National Disaster Coordinating Council (NDCC) with the National Disaster Risk Reduction and Management Council (NDRRMC). Step 3: The law shifted the national focus from reactive disaster RESPONSE to proactive RISK REDUCTION — preventing and reducing disaster impacts before they occur. Step 4: DRRM councils and offices are mandated at national, regional, provincial, city/municipal, and barangay levels. Step 5: The OCD (Office of Civil Defense) is the operating arm of the NDRRMC. The DOH-EOC handles the health-sector response but is not the body created by RA 10121.

Answer: B. Observing for distress, listening to survivors' needs without pressure, and connecting them to basic services and support networks

Step 1: Psychological First Aid (PFA) follows the framework of Look, Listen, and Link. Step 2: LOOK = observe for safety and for people showing distress or urgent needs. LISTEN = approach survivors, ask about their concerns, and listen without pressuring them to talk about the trauma. LINK = connect them to basic needs (water, food, shelter), accurate information, their loved ones, and social supports. Step 3: Option A is incorrect — routine group debriefing is NO LONGER recommended as an early PFA intervention and may even be harmful. Step 4: Option C is wrong — PFA is NOT formal therapy or psychiatric treatment; it does not involve prescribing medications. Step 5: Option D is wrong — suppressing emotions is not a PFA principle; PFA promotes safety, calming, connectedness, self-efficacy, and hope.

Answer: B. Mitigation

Step 1 – Identify what action is being taken: tree-planting and enforcing building codes are actions designed to REDUCE the impact of future disasters before they occur. Step 2 – Match the action to the correct phase: Mitigation refers to activities taken BEFORE a disaster to prevent or lessen its impact. This is distinct from Preparedness, which focuses on planning and readiness (e.g., drills, go-bags, warning systems). Step 3 – Eliminate the distractors: Response is during/immediately after a disaster; Recovery is after the disaster when communities rebuild; Preparedness involves training, stockpiling, and drills — not structural or environmental modifications. Step 4 – Confirm: Environmental and structural actions to reduce hazard risk are the hallmark of Mitigation. Key principle: 'Mitigation = lessening the blow before it happens.'

Answer: C. RED – Immediate

Step 1 – Recall the START sequence: After directing ambulatory victims to a safe area, you assess non-walking victims using RPM: Respirations → Perfusion → Mental status. Step 2 – Apply the Respirations criterion: A respiratory rate GREATER THAN 30 breaths/min immediately tags the victim as RED (Immediate). In this case, 36 breaths/min exceeds the threshold of 30. Step 3 – You do not need to assess further perfusion or mental status at this point — the respiratory criterion alone assigns the RED tag. Step 4 – Eliminate distractors: GREEN is for walking wounded; YELLOW is for those who pass all three RPM checks but are not immediate; BLACK is for those who are not breathing even after airway repositioning. Step 5 – Key rule to remember: RR > 30 = RED. This victim needs immediate intervention.